What Must Managed Behavioral Health Care Consider to be Appropriate for Children and Youth

All children, as a natural result of the process of growing up, are in a constant state of change. Every child is just a little bit different every day. Very young children grow rapidly and noticably. Change in school age children is less obvious but, nevertheless, there are big differences over the course of a year. At adolescence, some of the changes-both physical and emotional-are dramatic. Families constantly, and automatically, adjust their parenting and life style to suit the evolving abilities and needs of their children. It is this dynamic quality that makes children so very different from adults and creates their extended need for adult support and guidance. Family and child serving systems, including managed care, must have the flexibility to respond rapidly and appropriately to the changing physical, emotional, mental, and social development of infants, toddlers, children and youth.

Quality child and family serving systems, including managed care systems, therefore:

Systemmatially and frequently assess the child's situation and progress using what they learn to fine tune and improve services and supports,

Emphazise screening, prevention, and early intervention,

Attend to developmental stages and transition points which are critical for the child and,

Understand and respond quickly to developmental changes in the child and family.

All children, including those with mental, emotional, or behavioral problems, continuously require the support of their parents, siblings, and other family members. The family's culture and values provide the context in which the child develops and influences the way the child thinks, feels, acts, and responds to the world. The family, broadly defined is the most constant element in a child's life. Psychological ties to a family are maintained even when children leave home or the physical or legal bonds no longer exist. What families know about their children is more comprehensive than information gathered by an evaluation team at a specific point in time. Families have a longitudinal perspective on their child's development, behavioral patterns, characteristic responses to various environmental factors, preferences and idiocyncracies, and reactions to previous treatments. Child and family serving systems, including managed care systems, need to learn and respect what families know, think, feel, and believe about their childlren and the services and supports they are receiving. Serving a child means sharing responsibility for the child's care with a family. Services and supports, such as respite care, that enhance the quality of family life are necessary and legitimate uses of resources designated to serve a child.

Quality child and family serving systems, including managed care systems, therefore:

Respect the family's culture and values and organize and deliver services and supports accordingly,

Include the child's family in all phases of assessment and the design and implementation of services and supports, even when the child is placed outside of the home and,

Provide services and supports to sustain the family as a strong and viable unit that includes the child and to ensure that primary caregivers have the skills and resources they need to nuture the child.

The physical and mental health of children are intertwined with each other and influence development. Their need for food, shelter, clothing, education, and protection can bring children into contact with a variety of systems each with its own set of agencies, programs, and services. The education and physical health care systems are commonly experienced by all children. However, usually through no fault of their own, some children and youth will also encounter child welfare, mental health, substance abuse prevention and treatment. And, sadly, when these other systems fail, some children and youth find themselves in the juvenile justice system. Just as children grow in one piece, so must the child and family serving systems, including managed care systems, meet their needs in one coordinated, efficient and cost effective effort.

Quality child and family serving systems, including managed care systems, therefore:

Provide the child's family with the support of an individual responsible for ensuring close coordination across systems and communication and consistency among the different agencies and programs working with the child and family,

Conduct screening and assessment activities that explore the child's and family's strengths and needs across a wide range of domains with follow-up that gets all the necessary systems involved quickly and,

Actively engage in collaborative interagency planning to ensure the child and family are served efficiently and effectively.